Alpenrose Dinner-Dance Reservation Form

Weihnachtstanz Valencia Ballroom     December 11, 2011      

Doors open at 2:00 PM     Dinner at 2:30 PM     Dancing 4:00 PM. to 8:00 PM.

                                                        I plan to attend the dinner-dance with        _______ Members @ $32.00 each, Total________

                                                                                                                                         _______ Guests @ $36.00 each Total________

                                                                                                                                                                                    Grand Total________

Name_____________________________________              Telephone (            )_______________

Address____________________________          City/State________________       Zip________

Talk it over with whom you want to sit, ( It would be a great help) than let us know who is on your table, (tables of eight)

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Return by  no later than November 27, 2011.  Please no exceptions. Please no refunds after Deadline. Make checks payable to  (Alpenrose ) and mail to

 Al Langis 12 Culpepper Rd. Shrewsbury, PA. 17361. No Tickets are issued for this event.

_______________Separate here and pay separately_________________________________

Alpenrose Membership Renewal Form

Please renew ( my ) ( our ) membership to the German-American Society ( Alpenrose ) for 2012. Adult dues are $15.00 per year. Youth dues for 6 year olds through college are $7.50. The Deadline is March 31, 2012.

Please complete the information requested below.

Name: 1._________________________________________Name 2______________________________________

Street______________________________________________________________________________________

City:________________________State:__________________________Zip:_________________Telephone (       )________________

Send completed form and check payable to ( Alpenrose ) and a self-addressed, stamped envelope to [ Al. Langis 12 Culpepper Rd. Shrewsbury, Pa. 17361 ]

Date rec’d_____________________________                             2011 Card no. ___________________

Optional: Birthday 1.___________________                                     Anniversary:_______________________

                Birthday 2. __________________                                          E-Mail:______________________________